SANITY AND MADNESS

1.      Introduction

The Western world has made more noteworthy material wealth than some other societies in the historical backdrop of humankind throughout last two centuries. However, this “contemporary world” figured out how to slaughter off a large number of world population in a course of action, which called “war”. Despite this historical fact, numerous psychologists and psychiatrists reject to consider the idea that society might be lacking in sanity. Fromm (1963) claimed that they addressed madness in a society is only that the quantity of "unadjusted" people. Moreover they do not hold that a probable unadjustment of the culture itself.

Mental health specialists clash over the idea of whether Western culture causes labelling individuals as mad or madness is a real existence and deviance from normality. Foucault (1967) appealed that modernity is the most significant reason of mental illness. He explained his idea with underlying the role of the establishment of madhouses, which aimed imprisonment of the mad under the control of mental health specialists. These institutions were driven with two main motives. Firstly, governments used these places to ameliorate “mad” people away from their family- it was assumed that these persons might not afford the essential care at home. Secondly, governments aimed to protect society from undesirables and unhealthy “mad” persons with confining them. In progress of time, these institutions became the primary places where therapeutic treatment could be administered. Foucault sees these modern medical institutions as an inhuman and control machine. Because, he appealed that isolation of mad people cut off these individuals` communication with people who defined as modern normal men.

Erich Fromm (1963) approached the phenomenon of sanity same as Michel Foucault. He draws attention to how industrial western societies effect “sane” people and transfer some of them to a mad person. He claimed that modern sane man has lost his central place, he has been alienated and he has been made a mechanism for the economic aims. He also emphasized the psychological results of alienation. Initially, modern man becomes dependent on approval inasmuch as he loses his sense of self. Therefore, he inclines to conform and to feel insecure. He is bored, anxious and dissatisfied. To compensate or cover up these emotions, he spends whole of his time and energy. Fromm criticized western society for its detrimental effect on mental health. He claimed that the only way to attain mental health is simultaneous changes in the sphere of political and industrial organization, of philosophical and spiritual orientation, of cultural activities, and of character structure. He claimed that the only way to protect against the consequences of the madness was to create a sane society that suits the needs of the person. He sees these needs as the condition of human existence.

After given these existential approaches it may be useful to clarify the terms of sanity and madness.

2.      The terms of sanity and madness in a psychological context

The term of sanity is defined as the ability to think and behave in a normal and rational manner in Oxford Dictionary (Stevenson, 2010). In the Cambridge dictionary sanity is described as the state of having a healthy mind and not being mentally ill (Audi, 1995). As for madness, it is defined as the state of having a serious mental illness (Stevenson, 2010).

The words sanity and madness are not medical terms. Many people use these terms in a practical meaning than the medical terms of  normality and abnormality (psychosis). Madness is a general term that comprises behaviours considered deviant (Wilce, 2004).

Even though several descriptions of abnormality have been made over the years, none of them is entirely accepted (Maddux, Gosselin & Winstead, 2008). Most of the descriptions have certain features in common, often named “the four D`s”: distress, deviance, danger and dysfunction.

2.1. Deviance

Thoughts, emotions, and behaviours are counted as abnormal when they violate a society`s ideas about appropriate functioning. Each society creates norms, which called as implicit and explicit rules for appropriate conduct. Behaviours that break these defined norms of psychological functioning are described as abnormal. A society`s norms come from its peculiar culture, for instance, its values, institutions, history, skills, habits, arts, and technology. Thus, the appraisements of abnormality change from society to society.   A society`s values could also vary over time. This changeability may also cause changing society`s views of what is psychologically normal or abnormal as well. In western society, for instance, a woman`s involvement in the business world was extensively considered wrong and strange a century ago. However, today the same behaviour is valued, in other words it is normal (Comer, 2006).

2.2. Distress

Distress accounts for negative emotions, which have experienced by the individuals about their illness. They might feel deeply affected and troubled by their illness. Behaviours and emotions, which cause distress to others or to the individual itself, are described as abnormal. Many physical reactions arise from a strong psychological component; nausea, heart palpitations, and pain may all be symptoms of psychological distress. However, this criterion sometimes become invalid, for instance, an athlete may try to achieve an Olympic record with exhaustive and impairing exercises. In this case, it is unacceptable to accept that he/she is an abnormal person (Getzfeld, 2006).

2.3. Dysfunction

Abnormal behaviours incline to be dysfunctional. Therefore it impedes daily functioning. Dysfunctional behaviours may distract, upset, or confuse individuals that they cannot care for themselves appropriately, work productively, or participate in ordinary social connections. For example, sleeplessness, night sweating or tremor, which can be occured as symptoms of depression are dysfunctional behaviours. Nevertheless, dysfunction by itself does not automatically point to psychological abnormality. A plethora of people fast or deprive themselves of things they need as a means of devotions or protesting social injustice. Furthermore, far from receiving a clinical marker, they are widely seen as splendid sacrificing, opinion leader, even heroic (Nolen-Hoeksama, 2017).

2.4. Danger

Possibly, the ultimate point in psychological dysfunctioning is behaviour which becomes dangerous to others or oneself. Individuals whose behaviour is constantly hostile, careless or confused may be exposure to themselves or those around them at risk. Even though danger is often named as a characteristic of abnormal psychological functioning, research proposes that it cannot be generalised for all cases (Corrigan & Watson, 2002). Although popular misunderstandings, most people suffering from depression, anxiety, and even odd thinking pose no direct danger to anyone else or to themselves.

All these criteria show how individuals are labelled if they deviate from normality. So, what happens if people deviate from reality? In psychiatric jargon when a person loss her/his contact with reality, then he/she has a psychotic illness.

3.      Psychos as a Psychiatric Madness

Laing (1965) claimed that psychosis refers to a biological or social failure of adjustment, of lack of insight, of loss of contact with reality. However, it does not mean that every single psychotic has an unsound mind, needs care, attention in a mental hospital or may be dangerous to others and him/herself. At the same time, it does not mean that individuals who are sane, has a healthy mind, has not got a potential danger to others.

There is an approach, the existential-phenomenological construction, which suggest that any form of labelling is a prejudice which therapist opinionated toward client. The existential-phenomenological construction is an implication about the way the other is acting and feeling. Laing (1965) argued that looking a client`s action as ‘symptom’ of a ‘disease’ means imposing therapist’s categories of thought on to the client. Therefore, he suggested that psychosis or sanity should be tested by the degree of disjunction or conjunction between two persons where the one is sane by common consent. Moreover, asserting a person as a psychotic may depend on an incongruity, a clash and a lack of congruity between therapist and client. A therapist should recognize his/her client’s differentness, distinctiveness, despair, loneliness, and separateness. 

Similarly, but more radically, Symington (2006) argued that madness is a state which humans are born with. On the other hand, sanity is a state to be reached. If it is not reached, then it becomes traumatic. Trauma fundamentally is the lack of something essential for this achievement to be developmentally possible. Symington sees attainment of sanity as a mutual venture between infant and mother. This mutualistic relationship depends on contemplation of mother to her baby emotionally. The caregiver, mostly and naturally mother, requires to relate to infant with an active sense of wonder. Besides, contemplation comprises reverie, however, combines it into an act of emotional wonder. The birth of symbolic attachment is stimulated by this contemplative act. If this contemplative activity has not occurred, the fundamental trauma would happen. Those individuals, who could not attach with her/his mother safely, are diagnosed as mad.

4.      An Existential Model

Laing (1965) published ‘The Divided Self: An existential study in Sanity and Madness’ to explain how personality and culture transfer a sane person to a madness one. He argued that to comprehend the nature of the transition from sanity to madness, it is essential to contemplate the psychotic possibilities which developed out of specific existential context. An individual in order to be safe from the insistent danger and threat from the world and to sustain and improve his/her autonomy and identity may cut his/herself off from direct interaction with others. Moreover, he or she may have strived to become his/her own object. For this reason, he or she became related directly just to his/herself. Laing claimed that his/her fundamental became observation and phantasy. Additionally, if he/she becomes successful, self would have struggle in sustaining any sense of reality. It is not only about touching to reality, more dramatically he or she cannot truly 'meet' reality. In other words, it is a false-self system that thoughts, feelings, perceptions, and actions have a comparatively low 'coefficient' of realness. The person, who is in this position, may seem relatively normal. However, he or she is preserving his/her outward appearance of normality by gradually more and more abnormal and worried means. Laing (1965) addressed the self-engages in phantasy in the isolated 'world' of 'mental' things, i.e. of its own observes, and objects the false self, which alone is engaged in living in the 'shared world'. Subsequently direct interaction with others in this real shared world has been turned over to the false-self system. Consequently, what was designed in the first instance as a barrier or guard to avoid disruptive implosion on the self, may become the walls of a prison from which the self cannot escape. Therefore, the barricades against the world fail even in their main functions: to avoid persecutory implosion and to keep the self-alive, by avoiding being manipulated and grasped as a thing by another.

5.      The Effect of Western Culture

Erich Fromm (1963), who is a well-known German social psychologist and psychoanalyst, claimed that Western societies have a detrimental effect on human’s sanity. He argued that the concept of sanity might be understood by the examination of the "human situation" and the human needs and necessities which arise from its existence. Sanity, according to Fromm, cannot be defined in terms of "adjustment" of the person to his/her society. In contrast, it should have described in the terms of adjustment of society. Moreover, the society could have evaluated by its role in hindering or furthering the improvement of sanity. In other words, sanity or madness is predominantly not an individual matter, conversely, contingent upon the construction of his/her society. Fromm ranked the features of a sane society as individuals’ capacity to work creatively, to love him/her close relationships, to improve him/her objectivity and reason, to have a sense of self.   

6.      Conclusion

In conclusion both the psychology world and societies have different opinions about who is sane and who is mad. While those scientists, who are closer to the psychiatric view, are tend to explain mental health with individual-specific reasons, the others from anti-psychiatric and humanist views claim that the positive and negative effects of society on protecting the mental health are undeniable.

Bibliography

Audi, R. (1995). The Cambridge dictionary of philosophy / general editor, Robert  Audi. Cambridge; New York: Cambridge University Press.

Comer, R. (2006). Abnormal psychology / Ronald J. Comer. (6th ed.). New York: Worth.

Corrigan, P., & Watson, A. (2002). Understanding the impact of stigma on people with mental            illness. World Psychiatry: Official Journal of the World Psychiatric Association       (WPA), 1(1), 16-20.

Foucault, M. (1967). Madness and civilization: A history of insanity in the Age of Reason / Michel Foucault; translated from the French by Richard Howard. (Studies in Existentialism and Phenomenology). London: Tavistock Publications.

Fromm, E. (1963). The sane society / Erich Fromm. (Routledge paperbacks). London:       Routledge & K. Paul.

Getzfeld, A. R. (2006). Essentials of abnormal psychology. Hoboken, N.J: John Wiley.

Laing, R. (1965). The divided self : An existential study in sanity and madness / R. D.          Laing. London, England ; New York, N.Y., USA: Penguin Books.

Maddux, James E.; Gosselin, Jennifer T.; Winstead, Barbara A. (2008). Conceptions of      psychopathology: A social constructionist perspective. In Maddux, James E. (Ed);           Winstead, Barbara A. (Ed). (2008). Psychopathology: Foundations for a contemporary   understanding, 2nd ed., (pp. 3-18). New York, NY, US: Routledge/Taylor & Francis    Group

Nolen-Hoeksema, S. (2007). Abnormal psychology. Boston: McGraw-Hill.

Stevenson, A. (2010). Oxford dictionary of English. (3rd ed. / edited by Angus Stevenson. ed.).   New York, NY: Oxford University Press.

Symington, N. (2006). Sanity and madness. International Journal of Psychoanalysis, 87(4),           1059-1068.

Wilce, James M. 2004a. Language and Madness. In Companion to Linguistic Anthropology.          A. Duranti, ed. Pp. 414-430. Malden, MA.: Blackwell.